CMS extends Medicare freeze on new hospices and home health agencies for six more months

The Centers for Medicare & Medicaid Services will keep its nationwide freeze on new Medicare enrollments of hospices and home health agencies for another six months, the agency announced on November 12. The moratoria took effect on May 13, 2026, and were set to run for six months. CMS said the circumstances that led to them "have not yet abated."

We’ve made real progress over the past six months, but fraud in hospice and home health persists and our work isn’t finished.

The two extension notices were filed for public inspection on November 12 and are scheduled for publication in the Federal Register on November 16, according to the Federal Register's public inspection data. Under CMS rules described in the May notices, a moratorium lasts six months and can be extended in six-month steps.

What changes, and what does not

As before, the freeze applies nationwide, so operators cannot get around it by moving to another state, CMS says. It covers new applications for initial Medicare enrollment and certain changes in majority ownership. The new element is that hospices and home health agencies already enrolled may now add practice locations under their existing enrollment, which the May moratoria did not allow.

CMS says the extensions do not affect existing enrollments and do not stop enrolled providers from continuing to deliver services. When it imposed the hospice freeze, CMS wrote that it saw little evidence of nationwide access problems and would monitor for them. Its home health notice said more than 11,500 agencies remained enrolled nationwide, with no evidence of a shortage. In Medicaid and the Children's Health Insurance Program, CMS left it to each state to decide whether some form of hospice moratorium was appropriate, its hospice notice said.

Why CMS says it acted

In the May notices, CMS pointed to sharp growth in the number of providers in a few places. Between 2019 and 2023, enrolled hospices more than doubled in Arizona, California and Nevada, according to its data, while the number of beneficiaries using hospice grew far more slowly. CMS also wrote that home health agencies in Los Angeles County rose by more than 40% over the same years, and that the county had roughly 12% to 15% of all agencies nationwide but about 3% of Medicare beneficiaries.

The hospice notice described schemes in which patients were certified as terminally ill when they were not, and "churn and burn" operations that shut down once audited or capped, then start billing again under a new Medicare number. In its new announcement, CMS said site visit teams carried out a two-day operation in California in October that led to 145 revocations of providers associated with more than $703 million in Medicare and Medicaid payments.

The agency also cited its calendar year 2027 home health payment rule, which makes revocations retroactive to the date of noncompliance and adds grounds for denying or revoking enrollment, including requirements for hospices and home health agencies to reenroll after certain changes in majority ownership.

Earlier freezes and what comes next

CMS first used its moratorium power in 2013, for new home health agencies in Miami-Dade County, Florida, and Cook County, Illinois, and for ambulance suppliers in and around Harris County, Texas. Those moratoria were extended and widened several times before expiring on January 30, 2019, according to the May notice. In February 2026, CMS announced a separate six-month nationwide moratorium on medical supply companies.

There is no judicial review of a decision to impose a moratorium, the notice says. A provider denied enrollment can appeal only on whether the moratorium applies to it, and any application fee is refunded. CMS can lift a freeze early, for example if the circumstances behind it abate or after a disaster or public health emergency declaration. Its announcement includes no comment from hospice or home health industry groups.